Rationale: The Duette Device for endoscopic mucosal resection (EMR) is a recently developed technique for the staging and treatment of neoplastic lesions arising in Barrett's Esophagus (BE). There have been no comparisons between this device and the current standard, the Olympus EMR cap device. Aim: To compare outcomes (specimen size, completeness of resection and complications) following EMR using the Olympus EMR kit and the Wilson-Cook Duette Multiband Mucosectomy device. Methods: We compared data on outcomes following EMR using the Olympus EMR-001 kit and the WC Duette system in 30 consecutive patients with BE and HGD/Cancer referred to the Mayo Clinic Barrett's Esophagus Unit. A single experienced endoscopist (KKW) performed all procedures. The procedure was done as recommended for both methods with the exception of the use of dilute epinephrine solution with the Duette device. This was performed using a standard 25 gauge sclerotherapy needle placed through the Duette device. Tissue with the Duette device was retrieved using a Roth net. Data was prospectively gathered and analyzed. Results: 30 patients underwent 33 EMR sessions using the Olympus kit (Oly) (55%) and the WC Duette (WCD) device (45%). Number of specimens taken with each device? The 2 groups were comparable in terms of age, gender, length of BE segment and pre-procedure indication (HGD/Ca in over 90%) p > 0.1. Lesions seen on EGD in the 2 groups included nodules (71% Oly; 63% WCD) and mucosal irregularity (17% Oly; 20% WCD). The size of the visible lesions in the 2 groups was similar (1.2 cm versus 1.1 cm, p = 0.56). The rate of complete resection of the lesions was comparable between the two groups (50% Oly group and 60% WCK group). The size of individual EMR specimens was comparable in terms of length (1 cm Oly and 1.1 cm WCD) and depth (0.55 cm Oly and 0.67 WCD). One patient (5%) in the Oly group was treated with hemoclips for persistent oozing from the EMR site. One patient (6.6%) in the WCD group developed a stricture and was treated successfully with endoscopic dilation. Histopathology of the EMR specimens revealed carcinoma in 33% (is this right), high grade dysplasia in 43%, and either low grade dysplasia or non dysplastic BE in the remainder. Conclusions: In this preliminary report, EMR with the WC Duette Mucosectomy device appears to be comparable to that performed using the Olympus EMR kit in terms of specimen size and complications. Despite the application of bands, specimen sizes are not compromised with the Duette device.